<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Customers_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-customers_id" data-rule="required" data-source="customers/index" class="form-control selectpage" name="row[customers_id]" type="text" value="{$row.customers_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-type" class="form-control" name="row[type]" type="text" value="{$row.type|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Date_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-date_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[date_time]" type="text" value="{$row.date_time}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Teacher')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-teacher" class="form-control" name="row[teacher]" type="text" value="{$row.teacher|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Teacher_role')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-teacher_role" class="form-control" name="row[teacher_role]" type="text" value="{$row.teacher_role|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-number" class="form-control" name="row[number]" type="number" value="{$row.number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Validtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-validtime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[validtime]" type="text" value="{$row.validtime}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Appointed_by')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-appointed_by" class="form-control" name="row[appointed_by]" type="number" value="{$row.appointed_by|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Appointed_on')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-appointed_on" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[appointed_on]" type="text" value="{$row.appointed_on}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Currency')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-currency" class="form-control" name="row[currency]" type="text" value="{$row.currency|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Amout')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-amout" class="form-control" step="0.01" name="row[amout]" type="number" value="{$row.amout|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refundable')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refundable" class="form-control" name="row[refundable]" type="text" value="{$row.refundable|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cool_coin')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cool_coin" class="form-control" name="row[cool_coin]" type="number" value="{$row.cool_coin|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Description')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-description" class="form-control" name="row[description]" type="text" value="{$row.description|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
